Immunology Department, University Hospital of Saint-Etienne, 42055, Saint-Etienne, France.
Infectious Agents and Hygiene Department, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France.
J Clin Immunol. 2023 Jan;43(1):31-45. doi: 10.1007/s10875-022-01354-x. Epub 2022 Aug 25.
Reliable immunoassays are essential to early predict and monitor vaccine efficacy against SARS-CoV-2. The performance of an Interferon Gamma Release Assay (IGRA, QuantiFERON® SARS-CoV-2), and a current anti-spike serological test, compared to a plaque reduction neutralization test (PRNT) taken as gold standard were compared. Eighty vaccinated individuals, whose 16% had a previous history of COVID-19, were included in a longitudinal prospective study and sampled before and two to four weeks after each dose of vaccine. In non-infected patients, 2 doses were required for obtaining both positive IGRA and PRNT assays, while serology was positive after one dose. Each dose of vaccine significantly increased the humoral and cellular response. By contrast, convalescent subjects needed a single dose of vaccine to be positive on all 3 tests. Both IGRA and current serology assay were found predictive of a positive titer of neutralizing antibodies that is correlated with vaccine protection. Patients over 65 or 80 years old had a significantly reduced response. The response tended to be better with the heterologous scheme (vs. homologous) and with the mRNA-1273 vaccine (vs. BNT162b2) in the homologous group, in patients under 55 and under 65 years old, respectively. Finally, decrease intensity or absence of IGRA response and to a less extent of anti-spike serology were also correlated to reinfection which has occurred during the follow up. In conclusion, both IGRA and current anti-spike serology assays could be used at defined thresholds to monitor the vaccine response against SARS-CoV-2 and to simply identify non-responding individuals after a complete vaccination scheme. Two available specific tests (IGRA and anti-spike antibodies) could early assess the vaccine-induced immunity against SARS-CoV-2 at the individual scale, to potentially adapt the vaccination scheme in non-responder patients.
可靠的免疫测定对于早期预测和监测针对 SARS-CoV-2 的疫苗功效至关重要。比较了干扰素伽马释放测定(IGRA,QuantiFERON® SARS-CoV-2)和当前的抗刺突血清学测试与作为金标准的蚀斑减少中和试验(PRNT)的性能。80 名接种疫苗的个体,其中 16%有 COVID-19 的既往病史,包括在一项纵向前瞻性研究中,并在每次接种疫苗前和接种后 2 至 4 周采样。在未感染者中,需要接种 2 剂才能获得 IGRA 和 PRNT 检测均为阳性,而在接种 1 剂后血清学为阳性。每次接种疫苗均显著增加了体液和细胞反应。相比之下,恢复期患者只需接种一剂即可在所有 3 项检测中呈阳性。IGRA 和当前的血清学检测均被发现可预测中和抗体的阳性滴度,与疫苗保护相关。65 岁或 80 岁以上的患者反应明显降低。对于 55 岁以下和 65 岁以下的患者,异源方案(与同源方案相比)和 mRNA-1273 疫苗(与 BNT162b2 相比)接种的反应倾向更好。最后,IGRA 反应的强度降低或缺失以及抗刺突血清学的程度降低也与随访期间的再感染相关。总之,IGRA 和当前的抗刺突血清学检测可以在特定阈值下用于监测针对 SARS-CoV-2 的疫苗反应,并在完成疫苗接种方案后简单地识别无反应个体。两种可用的特定检测(IGRA 和抗刺突抗体)可以早期评估针对 SARS-CoV-2 的疫苗诱导免疫,以便在无反应患者中潜在地调整疫苗接种方案。